Yining Lu,1,2,* Jiaoran Liu,3,* Wei Chen,1 Pan Hu,4 Yan Pei,2 Yiming Gao,2 Hairong Lu,5 Ling Wang,1,2 Yingze Zhang1 

1Department of Orthopedic Research Center, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China; 2Department of Orthopedic Oncology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China; 3Department of Ultrasound Diagnosis, Bethune International Peace Hospital, Shijiazhuang, Hebei, People’s Republic of China; 4Trauma Medicine Center, Peking University People’s hospital, Beijing, China; National Center for Trauma Medicine, Beijing, People’s Republic of China; 5Department of Geriatric orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yingze Zhang, Department of Orthopedic Research Center, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China, Email yzzhang@hebmu.edu.cn Ling Wang, Department of Orthopedic Oncology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China, Email wangling2016uw@126.com; wangling2021@hebmu.edu.cn

Background: Hip fractures in the elderly triggers a severe inflammatory immune response.
Methods: Peripheral blood samples from 16 elderly hip fracture patients and 16 healthy controls were analysed for 92 inflammatory biomarkers using proximity extension assay (PEA) at different stages after trauma.
Results: Dynamic trends in inflammatory proteins after surgery were assessed. Correlation analyses showed significant associations between inflammation-related proteins and clinical parameters. A prognostic risk score model was developed: on day 1, CCL19, FGF-19 and MCP-2 were significant; on day 3, TGF-α, FGF-5, CCL19, IL-22RA1 and IL-12B were included; and on day 7, IL-2RB, CCL19 and 4E-BP1 were significant. High-risk patients had a significantly lower rate of recovery compared with low-risk patients.
Conclusion: In this study, we have highlighted the complex inflammatory response during fracture healing and emphasised the importance of long-term monitoring of protein dynamics.

Keywords: geriatric hip fracture, immune, inflammation, prognosis, Olink